The Wounds of Elisabeth Fritzl and Family

Elisabeth Fritzl's mental, physical and emotional wounds will require a network of case managers. So says Jeff Dolgan, senior psychologist at Denver Children's Hospital, adding that he had never heard of a case this horrific.

"It's beyond creepy," he said. "This takes the cake. Trauma is like throwing a big rock into a pond. The waves go out and we are all sadly traumatized. She will need a system of care, not just one person but an adult psychiatrist who will coordinate the rehabilitation. Her world has been this basement. It's like our waking up 500 years from now. This is all she's known."

Elisabeth Fritzl was incarcerated in a basement cellar for 24 years by her own father. She was repeatedly raped by him and bore him 7 children, one of which died shortly after birth and was incinerated in a furnace to get rid of the body. Elisabeth and her children were freed from their prison after a police investigation, prompted by the hospitalization of her eldest daughter Kirsten, 19, discovered their dungeon. Read the entire story here.

Physical Exam

After living for so long in the cramped, low-ceiling dungeon, called home for 24 years, Elisabeth and her kids have developed some serious physical problems. In her first medical exam after she was found, Austrian doctors said Elisabeth's teeth were horrifically decayed. She and her three children have a myriad of medical problems, including vitamin D deficiency, anemia and bad posture.

Vitamin D deficiency can cause rickets, a disease of malnutrition caused by lack of sun exposure that is rarely seen today. Her bones are weakened and deformed. Because of the cramped space, low ceilings and little opportunity to exercise, Elisabeth may also have problems with movement. She looks haggard, hunched over, lined and gray. The 42 year-old looks more like the sister of her 67-year-old mother than her daughter. Because of the scarce oxygen supply in the cramped quarters, Elisabeth and her kids had to spend long spells sitting or lying down. Kerstin, her 19-year-old daughter, is in an induced coma after collapsing. She is still in a critical condition and fighting for her life.

According to Dr. Stuart Goldman, a psychiatrist at Harvard University's Children's Hospital in Boston, "This case is so unique, we can only look for approximations."

"If you don't use muscles and stretch them out, your motion is limited," said Goldman. Muscles can be retrained, but senses like vision and hearing could be permanently impaired. He continued "All our senses are trophic. You have to use nerves for nerves to develop. If you patch an eye, you eventually go blind, even if the eye is mechanically normal."

Mental and Emotional Problems

Aside from the physical challenges facing the family, also of concern is the mental and emotional damage their incarceration may have caused. Although the Austrian doctors are worried about the three children, Elisabeth may have suffered the worst.

"She was older when it started happening, but at the same time, she had years and years of deprivation and limited stimulus," said Jay Reeve, associate professor of psychology at Florida State University and executive vice president of the Apalache Center for Mental Health. "It's exactly as if she was held in captivity in jail......She had some period of her life when, presumably, she was able to interact with others and be in school and have some social interchange," said Reeve. "But the rape and sexual abuse that she experienced was a pretty stark betrayal of trust."

Initially, her father Josef Fritzl, reportedly handcuffed Elisabeth to a metal pole and kept her in total darkness, returning only to bring her food or to rape her. She told police she was kept in a single room for the first nine years of her captivity where their children had to watch as her father repeatedly raped her. Often she had to decide whether to have sex or starve. She told officers how she quaked with fear every time she heard the door click as her dad came down for his vile sex sessions. He beat her if she struggled, so she soon stopped putting up a fight.

Police chief Franz Polzer said: "The man is evil beyond words. The misery he has inflicted on his family is unimaginable. It will take (Elisabeth and) the children years to recover."

With the complexity of her trauma, Elisabeth most likely has shut down emotionally as a way to cope with the pain and may need myriad therapies and time "to handle her memories and make sense of how why this happened," said Reeve.

Since being rescued, the family has been living in an isolated room in a psychiatric unit near their home. Doctors have placed a cargo container outside so that Josef Fritzl's captives can retreat there if they feel too traumatized by the daylight and the open space.

"She needs reassurance that she has not lost everything," said psychologist Dolgan.

On the video-sharing website Youtube there is a 5 part documentary on the discovery of the "House of Horrors" that Elisabeth and her children lived in. It is full of details about the experiences that she endured. Below is the first part of this documentary entitled The Josef Fritzl Story. Click here to see the entire series.